PDF(Pubmed)
Abstract：
We present a rare case of prolonged ileus caused by underlying Shigella infection after surgical hernia repair. Infectious disease is an uncommon cause of postoperative prolonged ileus in adults. Our 48-year-old male patient underwent bilateral open inguinal hernia repair and open umbilical hernia repair without complication at an academic institution, with same-day discharge. Eight days later, he presented to the emergency department with complaints of severe cramping abdominal pain, nausea, emesis, and watery diarrhea. Physical examination, computed tomography scan of the abdomen and pelvis, and abdominal X-ray were initially concerning for bowel obstruction. The patient was admitted to the general surgery service. Concern for ileus with underlying gastritis arose after a small bowel follow-through showed contrast eventually reaching the rectum. A subsequent gastrointestinal pathogens panel was positive for Shigella. The patient\'s symptoms resolved after appropriate antibiotic treatment. Shigellosis and other infectious diseases should be considered in the differential diagnosis of postoperative prolonged ileus.
摘要：
我们介绍了一例罕见的病例，该病例是由外科疝修补术后志贺氏菌感染引起的长期肠梗阻。感染性疾病是成人术后肠梗阻的罕见原因。我们的48岁男性患者在学术机构接受了双侧开放式腹股沟疝修补术和开放式脐疝修补术，没有并发症。当天出院。八天后,他向急诊科提出了严重腹痛的投诉，恶心,呕吐,和水样腹泻。体格检查,腹部和骨盆的计算机断层扫描，腹部X线最初考虑肠梗阻。患者被送往普外科服务。小肠随访显示造影剂最终到达直肠后，对肠梗阻和潜在的胃炎引起了关注。随后的胃肠道病原体小组对志贺氏菌呈阳性。经过适当的抗生素治疗后，患者的症状得到缓解。在术后肠梗阻的鉴别诊断中应考虑志贺氏菌病和其他感染性疾病。
